AB1535-HPR COURSE WITH GROUP SESSIONS TO START SELF-INJECTION OF BIOLOGICAL MEDICINE (ADALIMUMAB)
Authors: J. Schjerbech Bech, B. A. Esbensen, S. Skalsted Rasmussen
Journal: Annals of the Rheumatic Diseases (2022)

Background Denmark decided in 2018 that Adalimumab should be the first-line biological of patients with inflammatory arthritis. Consequently, a higher number of patients needed to be given information about Adalimumab and learn how to do self-injections. The department focused on making optimum use of its resources while at the same time ensuring a high medical standard for this new task. Objectives To examine whether group instructions with a structured approach will provide the medical standard required to enable the patients to perform their own treatment at home. And also to examine whether participation in group sessions where the patients will have an opportunity to exchange experience with other people in a similar situation would be beneficial for them. Methods Design: An anonymous questionnaire survey. Setting: The training sessions took place at the Center for Rheumatology and Spine Diseases, Rigshospitalet, Gentofte, Denmark, and involved patients who were already consulting the outpatient clinic. Participants: Patients, ≥ 18 year, due to start on their therapy with Adalimumab, were referred to the group sessions irrespective of previous diagnosis, previous experience with other forms of biological therapy and/or experience with self-injection. A group consisted of between two and six participants. Course structure: Initially the participants were given group instructions in subjects such as effect, adverse effects, storage and precautions to be taken in the event of an infection. The patients were also given theoretic instructions in the administration of injections and an introduction to the injection pen (test model). Following this, the patients administered self-injections individually in private under guidance. Material: The questionnaire asked about whether the participants felt capable of managing their therapy at home and whether they had benefited from being instructed in a group. In addition to this, the patients were asked about background data such as gender and previous experience with injection techniques and biological therapy. The questionnaire also left room to offer more detailed comments. Analysis: Descriptive data analysis, including also the more detailed comments from the questionnaires. Results A total of twenty-five patients with inflammatory arthritis divided onto seven groups. Female: 15; male: 10 Bionaïve, no experience with self-injection: 13 Bionaïve, experience with self-injection: 6 Previous biological therapy, no experience with self-injection: 2 Previous biological therapy, experience with self-injection: 4 Figure 1. After the group sessions, all of the patients felt they were capable of managing their own therapy and administering their own injections going forward. The patients were very much or to some degree happy that they were taught in groups and most replied that the questions/comments presented by the other participants were very relevant or relevant to some degree. Gender and previous experience with injection techniques and/or biological medicine did not affect patient satisfaction. Selected comments made by the patients: “Found the group approach to be really good. Good to hear what the others said” ; “It was really good to be part of a group. I would never have thought of asking the question that the other patients raised and it was relevant for me too” ; “Nice to listen to other people’s experience because it makes you realize that things may not be all that bad for you” ; “It was really good talking to others” ; “Always good to meet others in the same boat” Conclusion Group instructions with a structured approach are found to provide a medical standard which enables the patients to perform their own treatment at home. Participation in group sessions with others in the same situation as oneself is also found to be beneficial for the patients since this approach creates a space for dialogue and knowledge sharing by the participant. Disclosure of Interests None declared